Role of angiotensin-converting enzyme inhibitors in visceral angioedema

Korniyenko, Aleksandr; Alviar, Carlos L.; Cordova, Juan Pablo; Messerli, Franz H.

doi:10.1016/j.ijcard.2010.10.079

Cited by 6 publications

(4 citation statements)

References 39 publications

(45 reference statements)

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“…Clinical presentation includes nausea, vomiting, abdominal pain and diarrhea. 14 , 15 , 16 , 17 Symptoms typically present within 24–48 h after initiation of ACE inhibitor, 18 but there are case reports between 2 weeks and 18 months after initiation of therapy 13 and there is one case report 9 years after initiation of therapy. 6 …”

Section: Discussionmentioning

confidence: 99%

Isolated Visceral Angioedema Induced by Angiotensin-Converting Enzyme Inhibitor

Oliveira

Santiago

Carvalho

et al. 2016

GE Portuguese Journal of Gastroenterology

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Visceral angioedema is a rare complication of therapy with angiotensin-converting enzyme (ACE) inhibitors. Clinical presentation includes nausea, vomiting, abdominal pain and diarrhea. Early detection of this entity can prevent recurrent episodes and unnecessary invasive procedures, including surgery.This article describes a 46-year-old-woman who presented to the emergency department with abdominal pain, associated with nausea and vomiting. She had been taking ramipril for 15 days.A computed tomography was performed which revealed thickening of a jejunal segment, with submucosal edema.ACE inhibitor-associated angioedema was suspected and the medication was discontinued, with resolution of symptoms in 48 h.After 7 months of follow-up, the patient is asymptomatic.Despite of its rarity, ACE inhibitor-induced small-bowel angioedema should be included in the differential diagnosis when patients receiving ACE inhibitor therapy present with abdominal complaints.

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Section: Discussionmentioning

confidence: 99%

Isolated Visceral Angioedema Induced by Angiotensin-Converting Enzyme Inhibitor

Oliveira

Santiago

Carvalho

et al. 2016

GE Portuguese Journal of Gastroenterology

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“…ACEIs cause local increases in bradykinin levels by reducing the function of angiotensin‐converting enzyme, which inactivates bradykinin. In the presence of ACEIs, bradykinin can accumulate and interact with vascular bradykinin B2 receptors causing vasodilation, increased vascular permeability, increased c‐GMP and release of nitric oxide, which in turn cause oedema 5,6 …”

Section: Discussionmentioning

confidence: 99%

“…In the presence of ACEIs, bradykinin can accumulate and interact with vascular bradykinin B2 receptors causing vasodilation, increased vascular permeability, increased c-GMP and release of nitric oxide, which in turn cause oedema. 5,6 It is believed that polymorphism might lower the threshold for development of this complication, owing to an inherited lowering of bradykinin metabolism. If a predisposed individual starts taking an ACEI, angiooedema, might result as ACEIs further reduce bradykinin clearance.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin‐converting enzyme inhibitor and visceral angio‐oedema

Chuah

O’Donnell

2012

Emerg Medicine Australasia

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Abdominal pain can be a challenging presenting complaint with a broad differential diagnosis. Medication side-effect must always be considered. Visceral angio-oedema secondary to angiotensin-converting enzyme inhibitor use can cause abdominal pain. The association of angiotensin-converting enzyme inhibitor and visceral angio-oedema is not well recognized partly because the onset of angio-oedema might be delayed for months or years after commencement of an angiotensin-converting enzyme inhibitor. The epidemiology of angio-oedema is now changing in parallel with the increasing use of angiotensin-converting enzyme inhibitors. We present a case of visceral angio-oedema secondary to perindopril. This diagnosis requires a high index of suspicion because if not recognized early patients undergo extensive and expensive negative evaluation.

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“…Angioedema may involve any part of the body; however, the most common sites involve tongue, oropharynx, periorbital, and perioral areas [6][7][8]. Less commonly, angioedema may involve the gastrointestinal wall (visceral angioedema), which may present as a diagnostic challenge [10,11]. Less commonly, angioedema may involve the gastrointestinal wall (visceral angioedema), which may present as a diagnostic challenge [10,11].…”

Section: Introductionmentioning

confidence: 99%